The Cause of Obesity?

Depression, anorexia are examples about how finally it is a battle between higher cognitive signals and the biological drive. These are exceptions (deviating the norm) where the stimulus is so strong that it could override the basic drive. And we have animal studies which clearly shows a biological basis of obesity. They aren't really affected by social, cultural, economic and problems like anorexia.

Now it is true that some obesity can be due to genetic predisposition or genetic mutation (metabolic disorders, lymph-node issues, etc). But I utterly doubt that the majority of obese people are physically incapable of substantially altering their body fat through a reduction in highly caloric food and/or portion size and/or an increase in activity level.

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A genetic predisposition doesn't mean that it is physically impossible. If they eat less and work more, they will lose. But it is extremely hard. It would like me telling you to cut down to 5% body fat and just stay like that for the rest of the life. Sure it is possible, but pretty much guaranteed that you will never maintain. The same for most obese.

And in research is pretty clear that we are failing. Almost 80-90% of the people gain most of it back in 3-5years.

There are single gene mutations (5-10% -severely obese people) and complex interactions of a lot of genes that determine your obesity. It is just like height. It is not that the very tall people and very short people's height is due to genetics. Everyone's height is majorly determined by their genes. Or I should say 90% of the variation in height is from genes. Obesity is just second to height for genetic contribution.

I think you (anoop) are basing your inquiries too heavily in the post-1950's world. Something you are ignoring, or more probably - haven't considered is that 'obesity' is an extremely modern trend in the human race. To steal the analogy about the human race's existence in the universe being only a second on a 24hr 'history of the universe clock', obesity is probably occupying close to a similar amount of space on a 24hr 'history of the human race' clock.

This is not to say that there have not been obese people existing prior to WWII (that would be a farcical suggestion), rather that in the human experience there hasn't been a period prior to the last 70-80yrs where obesity was a financially or practically foreseeable outcome for 99% of the worlds population. Using the 'genetics' argument as a cause for obesity is ignoring the lack of obesity over the last X-thousand years.

Simply put: there's a significant element (or more than one) missing from that argument:

-People are eating more food than they need to, and in layman's terms, they're doing it because they can. This is a symptom of the 'American dream' (no, not aiming at Americans, just using the common term) that has dominated Western society since WWII; if you can access it (or think you can), then take it (witness the GFC and the sub-prime collapse as the major financial expression of this dominant mindset).

-People exercise less in modern Western society than they have in the past as a symptom of lifestyle, and vocation (simply put - you don't burn off as many incidental calories working from a desk as you did working as a farmer, labourer, miner, construction worker, builder, squiring for a knight, army foot-soldier, sailor etc).

-The doctrine of personal responsibility has been markedly less pronounced as a feature in societies collective consciousness. We are indoctrinated to believe that it is 'ok' to fail, that we should not have to bear fault for non-criminal acts (and even many criminal ones, witness the contradiction-in-terms that we describe as juvenile delinquency) and this is essentially the same problem that you're repeating: there is a SIGNIFICANT contribution of fault from obese people to their being obese.
---Obviously the contribution varies, and some people have thyroid disorders or other medical conditions that cause an over-eating situation.

My issue here is that you are attempting to say that one can point to ANY flaw in their eating or exercise behaviour and relate the cause to 'genetics', entirely (or near enough) ignoring psychological development and environmental stimulus.

Frankly speaking, it's amoral to use that argument (because if one can successively argue it - which you are nowhere near doing, no personal offense intended by that observation by the way) then the argument can be transported for ALL behaviour (criminal instincts such as murder, stealing, rape etc all the way through to fraud and contravening laws as was done leading up to the GFC, Enron collapse or even just lying - pick a scandal//example etc).

Personal accountability should not, and cannot be ignored or put on the way side here. It's like Lawrence Fishbourne says in Mission Impossible III:

Hell, if you want to talk about the genetics regarding height, do a case study on Michael Jordan.

It's correct that obesity should not be the cause of bullying and no one should attack someone for being obese, but this isn't debated. I've never heard someone say that they believe they're doing a non-negative thing when they make fun or deride someone for being over-weight.

Tangent - have you ever considered the morality involved in spending the amount of time and $$ that we do into studying obesity and cancer when the most serious disease and biggest single cause of death in the world is malnutrition? (and yes, it's a disease according to about 7 tenured Professors I'm aware of).

Something you are ignoring, or more probably - haven't considered is that 'obesity' is an extremely modern trend in the human race

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We just don't have any data. But we clearly know from writings that we had obesity even at the times of Hippocrates and Galen.

If you are genetically predisposed to obesity, you put on a lot of weight in an obsegenic environment. This is what we are seeing from all the survey data. The genetically inclined are pulling the mean of the whole population to the right.

I don't think you are bringing any sort of evidence into this discussion besides your opinions.

I never claimed obesity didn't occur, I said it wasn't a mainstream societal problem.

I'm telling you that your sample size is incredibly small and is a biased snapshot of human history. Are you talking genetics or not? The argument you're trying to sustain is essentially that genetics are the predominant cause of obesity, but you're ignoring that genetics haven't played that predominant causal role throughout history. Obesity is not a historically present health problem for the human race. The data you are using has almost negligible power, and you're treating it as canon law.

Malnutrition, susceptibility to foreign pathogens (bacteria, viruses, parasites etc), over//under heating - these are the major health concerns of the past 40,000 years and you're trying to assert that obesity is an "epidemic". What is the cause of this epidemic in modern times? That's what your "article" is missing.

The structure in Part 3 was especially disappointing. Self-appointed leading questions and you then assert to have convinced the reader; 'Ok, obesity is down to genetics ... what to do?' - exceptionally poor persuasive writing here. I understand what you are trying to accomplish but it isn't working at this stage.

I wouldn't have written if there was no practical application. I guessing you missed the third part. I am posting it below where alot of people asked the same question. Is it gong to change anything.

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I read it, and again I find it pointless in the end. Here's why:

Obese people will set realistic goals (5-7%). Most people set weight loss goals looking at magazines or they think they have to come down to normal BMI to be called 'healthy'. If it can be maintained without extreme difficulty, try to lose more.

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If obese people were realistic to begin with they wouldn't be obese. If you tell a fat person trying to lose weight that 'realistically' they're going to have to spend the next ten years 'dieting', they'll likely eat you out of spite. You're just prescribing what you think is the realistic and achievable way of doing things. More books and websites and screaming trainers in spandex than can be counted have already done that to no avail. That your approach is evidence based doesn't matter because no one gives a damn about the evidence, especially if it's telling them something they don't want to hear.

People will immediately focus more on weight maintenance than weight loss.

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Why, because you say so? Because the 'evidence' says that's what they need to do? People won't think long term, they'll think to the time horizon they always think to, which is different for all people.

People will finally stop looking for the perfect diet or bothering incessantly about whether it is fructose, crabs, fat and so forth. They will finally stop blaming their diet for failing them. There will be less stress wasted on diet books.

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Again, why? Disseminating the evidence, no matter how reliable it is, just makes you another voice among the crowd. Evolution has been around as a theory for a century now, tested and proven in the lab and with real world observations. Lots of people still don't believe it and prefer the invisible sky elf explanation for everything. You're assuming people are 'rational'. They're not. They are only rational in the weakest sense in that they are goal oriented. But they still do the equivalent of dancing to make it rain a lot of the time though because they aren't rational in the strong sense of the word which is what they would need to be for a true evidence based approach to matter.

Normal weight and lean people would look at obese from a different perspective - one filled with compassion and empathy.

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No, they won't. People are pricks, they always have been and always will be.

And for the most important part: Obese people will finally understand that it was never their fault. They will finally be free of their endless self-blaming, depression, and lack of self-esteem that they had to endure their ther whole life.

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And here is the ultimate reason I disagree. It is their fault. I'll go further: I'm overweight right now and it is my fault. All the genetics and biology in the world doesn't change the fact that no one forced anyone, or me, to shove too much food in down our throats. We may have urges. We may have a nice domamine cascade that makes us feel good with every twinkie and nacho. We may have a genetic glitch that makes us notoriously bad at estimating calories or satiety. The bedrock reality though is we are subject to the physical laws of this universe and while our minds and stomachs might lie to us, our expanding wastelines can't; we're obviously in calorie surplus. And when I look at the weight loss industry these days all I see are a bunch of people desperately trying to tell/sell every fatty that it's not their fault, up to and including telling them that there's a magic elf living in them called insulin which allows them to violate the laws of physics, laws that even apply to black holes, but not their stomachs.

I call BS on this approach. Taking responsibility for the fact that you control your own actions up to and including what you feed yourself is the first and necessary step everyone must take before they can make any lasting change. As long as you've got something else to blame you'll always eventually fall back on that and stall at some point. And it's not that I don't appreciate the kind of work people like you do, I appreciate it very much. I'm all for more knowledge and better information. But when it comes to weightloss and the masses I truly think you're pissing into the wind with this approach.

I never claimedobesity didn't occur, I said it wasn't a mainstream societal problem.I'm telling you thatyour sample size is incredibly small and is a biased snapshot of human history.Are you talking genetics or not? The argument you're trying to sustain isessentially that genetics are the predominant cause of obesity, but you're ignoringthat genetics haven't played that predominant causal role throughout history.Obesity is not a historically present health problem for the human race. Thedata you are using has almost negligible power, and you're treating it as canonlaw.

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And I am not trying to say that if we take these obese people and put them back in the stone age, they wouldn’t lose weight. They would lose weight, but they will still be fat, although less fat.

In an environment where food is abundant, people who have genetic pre-disposition just cannot control their drive for food/and gain a lot more fat than the lean would have for the same amount of food. This clearly seen in Flegal's data where people who are obese gaining 25-35 lbs where as thelean are gaining 1-3 lbs in a decade.

Malnutrition,susceptibility to foreign pathogens (bacteria, viruses, parasites etc),over//under heating - these are the major health concerns of the past 40,000years and you're trying to assert that obesity is an "epidemic". Whatis the cause of this epidemic in modern times? That's what your"article" is missing.

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It is not missing it.In fact, that's the whole of my second article is based on.

Again, this is not intended as personal offense - I don't know anything about you beyond the bio on your site - but your 2nd "article" addresses none of the critiques I have raised.

For example:

[h=2]How would the graph be if it was largely environment?[/h] Environment: If it was largely environment, everyone would have been equally affected and would have gained a lot of weight. The curve would have shifted to right a lot with no skewness. This will show that there is no overriding factor for obesity. Everyone will get really fat!

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This doesn't address personal environments and psyches at all. Your writing in no way addresses the input of parental upbringing, child-environment, adolescent environment, psychological impacts affecting body image, comfort eating, depression - the list goes on and on. Take Margaret Morris' work for example ( http://www.med.unsw.edu.au/medweb.nsf/page/MargaretMorris - it's not her studies, just an overview, finding the published studies shouldn't take much time at all).

Yes, genetics determine the ceilings and boundaries of physiological expression and separate the 'everyday' person from elite athletes (that gain muscle more easily, have a better LBM : Adipose ratio etc), but they are not exclusively determinative. The degree of gene expression that occurs is directly (and indeed indirectly) influenced, affected and moderated by the physical and psychological environments of the subject.

Hell, in your 2nd "article", the graphs you present better support the contention that environmental and psychological changes are more greatly responsible for increased obesity in Western culture than the role of genetics. What has changed in the genetic pool in the last 2 generations ... ? Sweet f*** all. What environmental changes have occurred?

-Increase in saturated fats and refined sugars (high caloric foods)
-More sedentary life-styles
-Less personal responsibility as a feature of Western culture (in layman's terms, it's the Jurassic Park problem. Doing something because you can rather than should)
-Increase in available food
-Decrease in effort required to obtain food (as Jeremy Irons says in 'Margin Call', money exists so we don't have go around clubbing each other just to get a meal)

The scientific reasoning you're employing in your "articles" abandons first principles. Notice//inquire, hypothesise, experiment&observe, match up and conclude. You're taking disconnected data and connecting them the same way a freight train has inter-linked carriages. What you should be doing is analysing the data separately and looking for commonality and trends that supports the contention that genetics are the primary factor leading to obesity and not environmental and psychological influences. Instead, all that your 2nd "article" really does is observe that the USA is getting fatter.

Hell, even simpler than that, Occam's razor - the simplest explanation is more often than not the correct one (and no, this doesn't imply that genetics need to be simple, it's talking about an explanation known data and observations).

People have access to more food. Eating food is enjoyable. People eat more food. There is no stimulus to eating more food (as you eat it). People don't stop fulfilling their enjoyment (the biological imperative at work).

Your explanation is that at some point in the 20th century, genetic expression levels changed and a significant % of the population started gaining weight due to these genetics. The # of factors that would have to coincide for genes to all of a sudden become problematic in a specific subset of the population (basically anyone with money only, which means at most about 20% of the population of the planet but realistically more like 10-15%) is absurd.

Obesity, in the overwhelming majority of cases is because people eat too much without having a reason to stop and the amount of calories they expend is significantly lower than the amount they're consuming.

Why do they eat too much? Because it feels good to eat, same as sex. Evolution figured out that a species will survive if it had a reason to engage in the behaviours that lead to this. Eating and proliferation are both pretty frikkin' great (the latter obv. being king of the world). Why do they need the 'good feeling'? - any # of reasons, each person will have a different mix.

The massive increases in food alter the physiology of the subject (new fat cells rather than just full fat cells, damage to insulin production, heart wall changes) and after a threshold is crossed, some of the changes become irreversible.

There is obviously genetic variation at work here, but genetics are not the CAUSE of obesity, they merely play a role.

Thisdoesn't address personal environments and psyches at all. Your writing in noway addresses the input of parental upbringing, child-environment, adolescentenvironment, psychological impacts affecting body image, comfort eating,depression - the list goes on and on. Take Margaret Morris' work for example - it's not her studies, justan overview, finding the published studies shouldn't take much time at all).

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If we agree thatparental upbringing, child-environment, and so forth are all affecting then you we have to admit that the peoplewho are on the higher BMI are greatly affected by these. If all these factors were affecting everyone (and it should), the curve should have shifted to the right as a whole and not a right skewness. What does that tell you?

Hell, in your 2nd"article", the graphs you present better support the contention thatenvironmental and psychological changes are more greatly responsible forincreased obesity in Western culture than the role of genetics. What haschanged in the genetic pool in the last 2 generations ... ? Sweet f*** all.What environmental changes have occurred?

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Did you even understand the point of that 2nd article I was tryin to make? The article says that though it's called an obesity 'epidemic' the average weight gain is a very modest 6-9lbs. This 6-9 lb is what is showing 33%and 66% percent increase in obesity!! When it is put in percentages, it always shock people. This is even said by Flegal who wrote the very same papers to show the obesity 'epidemic'.

This is what happenswhen we have cut off for a continuous trait. Even 1-2 lb increase in weightwill push a lot of people over that cut off and make it look a big percentage increase.

Your explanation is that at some point in the 20th century,genetic expression levels changed and a significant % of the population startedgaining weight due to these genetics.

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No. I am saying if you are genetically predisposed to obesity, you will gain lot of weight in an environment where there is free access to food. If you are not, you won't. And its' not my idea. I heard it from Friedman. He discovered Leptin.

And just so that you know lean people enjoy food too.

And Alex let's try to stick with points we are discussing rather than going on a tangent about logic and science.

No. I am saying if you are genetically predisposed to obesity, you will gain lot of weight in an environment where there is free access to food

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Because you won't stop yourself from eating too much . . . it really is NOT that difficult to stop yourself from over-eating, it just takes will-power//personal strength (call it whatever you like). I know this from my experiences as a formerly obese individual. Now I'm sure in your mind right now you are telling me//thinking at the screen that genetics will dictate how 'easy' it is for one person or another to force themselves to stop eating, and genetics make it harder for others ... and I'm telling you that this hasn't been proven in the slightest (genetics being the cause).

If you're a follower of predetermination as a universal theory then sure, I have no doubt that you're willing to ascribe to the theory above. But given that it's impossible to take the eating habits of someone and monitor them free of the environment and influence of the (already) X-years they've been alive, you're going to end up rather short.

Yes, of course there are variations across the billions of humans; no one is disputing this. That doesn't mean the predisposition to obesity = cause of obesity.

What you wrote wasn't controversial, it's merely speculative. This isn't a controversy, no one here is reacting to a proven stream of facts, we're reacting in disagreement to you because you haven't succeeded in proving your point. The "articles" are not well written. They lack structure, narrative, and a pretty decent chuck of data. That's not a crime, it just means that no one here is convinced by the essentially 'nothing' you've presented.

Anoop, Europe has a different food culture (advertising, ingredients, portions,...) than the US. I'm sure you've read this is a possible factor for the much lower obesity rate there. Is the estimated percentage of obesity genertcs very close to the obesity rate in Europe?

Because you won't stop yourself from eating too much . . . it really is NOT that difficult to stop yourself from over-eating, it just takes will-power//personal strength (call it whatever you like). I know this from my experiences as a formerly obese individual. Now I'm sure in your mind right now you are telling me//thinking at the screen that genetics will dictate how 'easy' it is for one person or another to force themselves to stop eating, and genetics make it harder for others ... and I'm telling you that this hasn't been proven in the slightest (genetics being the cause).

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And about you rpersonal experience: This is called the availability bias. Skewing the frequency of things because one event made a big impact in your life. This is how most people argue on this topic - just a knee jerk response. In research, we clearly know the 80-90% of the people who lose weight gain it back. Since you lost weight, you have conveniently ignored the statistics. This is one ofthe biases we all have.

Bouchard has clearly shown that for the same calorie intakeand expenditure, people lose different weight. In one study where identical twins ate the same amount of calories in a controlled environment, the variation ranged from 12llb to 28 lb! So some people find it easy to lose weight and some find it extremely hard. Don’t just extrapolate your experience on others.

Again not a shred ofevidence, but a lot of enthusiasm. Thanks anyways.

Anoop, Europe has a different food culture (advertising, ingredients, portions,...) than the US. I'm sure you've read this is a possible factor for the much lower obesity rate there. Is the estimated percentage of obesity genertcs very close to the obesity rate in Europe?

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Hi QuantumPositron,

I had a lot data when I was writing the article. Just don't remember most of it now. And in developing countries it is low too.

As I said when they say obesity is climbing everywhere, it is just showing the the increase in prevelance. So even of there is a 1-2 lb increase in a decade, there will be a big increase in obesity prevelance. Sure the environment has contributed to the 15-25 lbs, but this is totally different when people are 100-200 lbs heaver you know.

And I looked the obesity reports from New Zealand and Australia, they all show the same skewed curve. The obese getting way way heavier than the lean and making the whole population heavier.

And watch the Friedman presentation if you get a chance. It is not my idea. He might have a bias since he discovered Leptin.

The fundamental question is here how much weight is person putting on in their life time. I haven't had any exact numbers since it seems to be different for different ethnic groups and BMI levels. And people always put on some weight with ageing.

It's a nice article, Anoop, but it's not saying anything that hasn't been already addressed. So their hormones were messed up and their bodies were in ultra efficient mode so they could store every gram of fat possible? This doesn't change the fact that without the raw material they wouldn't have put the weight back on. So all this is saying is that weight loss and maintaining weight is harder for some people than others. Some people put on fat more easily for any number of reasons while others don't. To the extent this might help any individual stay at a healthy weight I'm all for studying it. But the simple fact remains that at the most basic level we're talking about energy in the form of chemical bonds that our bodies break and reform to maintain existing tissue, and we can't build new tissue unless we're giving our bodies the raw materials, the actual atoms themselves, to build that tissue with. So it still comes down to calorie excess.

The only thing this research is good for is maybe finding ways to help such people fight hunger and their body's natural inclination to urge them to eat more when they really don't need it. But then again, since we know conservation of mass and energy is the governing rule in this anyway, we already knew that. Some people differ in how they handle calories, we know this. But energy balance is the ultimate governor of things in this case so all they're really doing is fleshing out some details. Ghrelin makes people hungry and formerly fat people have more of it. Great, one more brick in the wall of our understanding. But the ultimate truth still remains: we have to either find a way for them to consume fewer calories or burn more, or a combination of both, to maintain their lower weight. Whether it's increased hunger or complete lack of will power that leads to them eating more is only helpful to them.

The onlything this research is good for is maybe finding ways to help such people fighthunger and their body's natural inclination to urge them to eat more when theyreally don't need it. But then again, since we know conservation of mass andenergy is the governing rule in this anyway, we already knew that. Some people differ in howthey handle calories, we know this. But energy balance is the ultimate governorof things in this case so all they're really doing is fleshing out somedetails. Ghrelin makes people hungry and formerly fat people have more of it.Great, one more brick in the wall of our understanding. But the ultimate truthstill remains: we have to either find a way for them to consume fewer caloriesor burn more, or a combination of both, to maintain their lower weight. Whetherit's increased hunger or complete lack of will power that leads to them eatingmore is only helpful to them.

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Nope. You are missing the point.

Do you know why the federal goals for any weight loss program is a meager 5-7%? Do you know why“success” in weight loss treatments is a weight loss of >=5% of bodyweightmaintained for 1 or more years? Do you know why more and more experts are focusing more on exercise and eating healthy than just weight loss? Because we are slowly coming to know there is clear biological basis for obesity and it is hard for the majority to lose and maintain it though it sounds great in theory.

And do you now whypeople come up with these exaggerated weight loss goals? Do you know why obesepeople are thought of lacking will power and self control? Because people gotno ****ing clue about the biological basis of obesity.

And watching every morsel of food that goes in to your mouth is called an OCD (not will power or discipline). It is not normal behavior.

Do you know why the federal goals for any weight loss program is a meager 5-7%? Do you know why“success” in weight loss treatments is a weight loss of >=5% of bodyweightmaintained for 1 or more years? Do you know why more and more experts are focusing more on exercise and eating healthy than just weight loss? Because we are slowly coming to know there is clear biological basis for obesity and it is hard for the majority to lose and maintain it though it sounds great in theory.

And do you now whypeople come up with these exaggerated weight loss goals? Do you know why obesepeople are thought of lacking will power and self control? Because people gotno ****ing clue about the biological basis of obesity.

And watching every morsel of food that goes in to your mouth is called an OCD (not will power or discipline). It is not normal behavior.

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The biological basis for obesity can't trump the physical basis for obesity. And that basis is positive energy balance.

I don't understand how someone could become obese without a positive energy balance, regardless of genetics and environment.

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Hi totentanz,

I think everybody knows that. Hippocrates wrote this 2000 years back. And it hasn't changed anything still.

The question is why are some people being obese while some staying lean within the same toxic environment. Or all the lean people watching the diet and counting calories? No.

And there is clear evidence in animal studies and twin studies that genetics plays a very large role. Obesity is only second to height when it comes heritable traits! Twin studies are the only way we can study the heritability of a trait. The twin studies by Wardle in 2008 was done to see if the current toxic environment would decrease the heritabilty of obesity, but it didn't.

The only question researchers have and are confused is if obesity has a large genetic component, why is current obesity trends going up so high. And this is the only argument against the genetics of obesity. And that is where the prevalence data comes in and how we are talking about a modest weight gain.

Here is short interview with Dr. Arya Sharma - one of the leading obesity experts. He talks exactly the stuff that this thread is all wrong about. The mentality of lacking will power, eat less, work more and how it is all a personal choice.